Increased levels of YKL-40 in patients with diabetes mellitus: a systematic review and meta-analysis

Abstract

Background Diabetes mellitus (DM) could be classified as type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM) and others according to etiology and pathology. Diabetic nephropathy (DN) is one of the most serious complications of DM. YKL-40 is a marker of inflammation and some studies have indicated that DM was related with inflammation. The objective of our study is to perform a systematic review and meta-analysis to confirm the relationship between YKL-40 and DM as well as DN. Methods Pubmed, Embase, CNKI and Chinese wanfang databases were searched for eligible studies by two independent authors. Studies were included in this meta-analysis if they fulfilled the following inclusion criteria: (1) a study involving the role of YKL-40 in DM (or DN) designed as a case–control study or cohort study; (2) the data of serum YKL-40 levels were available; (3) studies were published in English or Chinese. Finally, twenty-five studies were included in this meta-analysis. Results Compared with healthy controls, DM patients had significantly higher levels of YKL-40 (DM: SMD = 1.62, 95% CI 1.08 to 2.25, P = 0.000; GDM: SMD = 2.85, 95% CI 1.01 to 4.70, P = 0.002). Additionally, DM patients with different degree of albuminuria had significantly higher levels of YKL-40 compared with healthy controls (normoalbuminuria: SMD = 1.58, 95% CI 0.59 to 2.56, P = 0.002; microalbuminuria: SMD = 2.57, 95% CI 0.92 to 4.22, P = 0.002; macroalbuminuria: SMD = 2.69, 95% CI 1.40 to 3.98, P = 0.000) and serum YKL-40 levels increased with increasing severity of albuminuria among DM patients (microalbuminuria vs normoalbuminuria: SMD = 1.49, 95% CI 0.28 to 2.71, P = 0.016; macroalbuminuria vs microalbuminuria: SMD = 0.93, 95% CI 0.34 to 1.52, P = 0.002). Conclusions Our current meta-analysis demonstrates that serum level of YKL-40 is increased in DM and positively associated with the severe degree of albuminuria. Therefore, we suggest that YKL-40 could be considered to be detected, along with other inflammatory markers, if DM, especially DN, is suspected.

Serum chitotriosidase and YKL-40 in acute pancreatitis: Reliability as prognostic marker for disease severity and correlation with inflammatory markers

“…YKL-40 and chitotriosidase belong to the same family, “mammalian chitinase-like proteins,” but YKL-40 is not a chitinase; rather, it binds tightly to chitin particles [ 28 ]. YKL-40 is a potential serum biomarker of distinct benign and malignant disease states, including diabetes mellitus, coronary artery disease, systemic sclerosis, psoriasis, dementia, benign prostatic hyperplasia, cervical cancer, and primary prostate cancer [ 14 – 17 , 28 , 29 ]. Unfortunately, there is scarce evidence for an association between YKL-40 and AP.…”

YKL-40 as a biomarker in various inflammatory diseases: A review

“…Higher serum concentrations of YKL-40 are associ-ated with severe forms of the inflammatory diseases and consequently poorer prognosis, implicating its potential role as a biological marker in the prediction of the inflammatory response severity (37,(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57). Results of recent human studies in patients and healthy controls are presented in Figure 2.…”

“…YKL-40 plasma concentrations are 2-3 times higher both in patients with type 1 and type 2 DM compared to the normoglycemia group (48,69). In type 2 DM patients with concurrent obesity, YKL-40 influences insulin sensitivity through the stimulation of inflammatory chemokines production in activated adipose tissue macrophages (69).…”

Microalbuminuria como detección en diagnóstico precoz de nefropatía en pacientes diabéticos

“…País Hallazgos (Luo, 2021) 2017 China Los pacientes con DM2 y aquellos con albuminuria, chinos o no chinos, tenían niveles elevados de factor de crecimiento transformante beta 1 (TGF-β1) en suero y orina. (Mansoor , 2020) 2019 África La comparación de métodos para la medición de la creatinina para evaluar la función renal (Penno, 2018) 2020 Corea…”

“…También la glicoproteína de unión a quitina de 40 KDa (YKL-40) tiene funciones biológicas que aún se desconocen. Se considera un marcador inflamatorio e indicador de disfunción endotelial, que se encuentra elevado en la DM2 y la DM1 y aumenta junto con la albuminuria (Luo, 2021).…”